On August 11, 2007, a 43-year-old male volunteer fire fighter died while he was responding to an automatic alarm driving an engine. Less than half-mile from the station, the victim rounded a curve and went off the right side of the road onto the shoulder, swerving to miss a vehicle that crossed over the centerline from the opposite direction. The victim steered the engine back onto the road and crossed the centerline. While attempting to control the engine the victim overcorrected and again ran off the right side of the road. The engine collided with a fenced embankment, skidded side ways, struck a tree, and overturned. The engine came to rest lying on the driver's side of the road. Fire fighters responding in a ladder truck from the victim's department found the victim entrapped in the cab of the engine, within a minute of the incident. The victim was found to be unresponsive and was pronounced dead at the scene by Emergency Medical Services (EMS) personnel. Key contributing factors identified in this investigation include: driver training, unsafe speed for roadway conditions, the potential of the driver's inexperience with driving a fire department vehicle under emergency conditions, sharp shoulder drop-off, and the unsafe driving by a civilian driver. NIOSH investigators concluded that to minimize the risk of similar incidents fire departments should: 1. enhance their driver/operator training programs to include road and apparatus hazard recognition and emphasize the need for new drivers to understand and recognize the potential hazards which may occur while operating a fire department vehicle during emergency operations; 2. consider requiring that emergency vehicle operators/drivers receive driver training from a State or other nationally recognized training program, in addition to specific departmental driver training; 3. establish, implement, and enforce standard operating procedures (SOPs) that incorporate guidelines for safe and prudent driver/operator training and include detailed curriculum for the classroom and hands-on training that is specific to the roadways within their jurisdiction and for each apparatus; 4. attempt to establish working relationships with roadway authorities to identify and correct roadway hazards (e.g., drop-offs, potholes and other road deformities) on the roads and highways within their jurisdiction; 5. consider working with municipalities to impose a false alarm ordinance that targets facilities that fail to adequately maintain their alarm systems.